Thrombin, the central regulatory molecule of blood coagulation, is produced by prothrombin (II) proteolysis by a platelet-membrane-bound enzyme (factor Xa) and its associated cofactor (factor Va). The membrane accelerates II activation by 105-fold. Upon activation, platelets give off vesicles with phosphatidylserine (PS) and phosphatidylethanolamine (PE) on their surface. Contrary to a widely help paradigm, our work shows that PS molecules, not a membrane surface, trigger this remarkable acceleration. This has eluded researchers because PS is located in membranes where protein structure and interactions are very difficult to study. To show this, we used a short-chain soluble form of PS (C6PS), which does not occur in vivo, but is an invaluable tool for revealing effects that are masked by membranes. Once revealed, these effects can be confirmed by careful experiments with membranes. We now ask three questions to extend our understanding of lipid regulation of human blood coagulation. Does PS plays a similar regulatory role in other key proteolytic reactions involved in blood coagulation? Factor IXa with its cofactor VIIIa and factor VIIa with its cofactor tissue factor activate factor X to Xa. Factors IXa and VIIa are structurally similar to Xa, as is cofactor VIIIa to Va. Preliminary results show that IXa and VIIa both respond to C6PS. Activated Protein C (APC) is a key down-regulating enzyme that is sensitive to PS-membranes and, in preliminary studies, to C6PS as well. We hypothesize that PS regulates IXa, VIIa, and APC as it does Xa, and regulates VIIIa as it does Va. If we confirm our hypotheses, it will mean that exposure of PS on activated platelet membranes is the key regulatory event that turns on the amplification stage of blood coagulation. PE in membranes also influences the activity of the II-activating complex. We ask how? Recent results show soluble C6PE regulates Xa and Va. We hypothesize that molecular PE has a regulatory role similar to that of PS in II activation and it accomplishes this though PE regulatory sites linked to PS sites. What are the structural mechanisms by which PS binding to regulatory domains near the membrane influence events far removed from the membrane? We have limited information about the atomic structure of the Xa-Va complex or of Xa and Va when bound to PS. We have cross-linked a Xa-Va complex assembled by C6PS and will determine if it would be appropriate for crystallization trials. We will also use mutational FRET labeling, and mass spectroscopic analysis of cross-linked and modified proteins to provide experimental constraints to improve existing models for Xa and Va, and test our hypothesis that PS binding produces internal domain rearrangements that provide the structura basis of PS regulation. PUBLIC HEALTH RELEVANCE: Prothrombin (II) activation to thrombin is key to blood coagulation, since thrombin is the central regulatory molecule of blood coagulation. Failure to regulate its production and inactivation can lead to stroke and heart attack. Membranes from activated platelets display two phospholipids not exposed to plasma in resting platelets: phosphatidylserine (PS) and phosphatidylethanolamine (PE). We showed that molecular PS regulates all the clotting factors involved in thrombin production. We ask now: Does PS plays a similar regulatory role in other key proteolytic reactions involved in blood coagulation? Does molecular PE influence the structure and activity of any of the coagulation factors regulated by PS? If so, why is this second regulatory molecule necessary? What are the structural mechanisms by which PS (PE?) binding to clotting proteins near the membrane influence binding and catalytic events far removed from the membrane? We expect to show that PS (and PE?) exposure on platelet membranes is a new signaling motif that regulates the coagulation process. Results to date have produced a patent for an improved coagulation factor assay and are expected to yield drugs/procedures for managing coagulation in a clinical setting.